Top Carers Nursing and Domiciliary Care Agency

Updated 23 July 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

Our inspection was completed by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced. We gave the service 48 hours' notice of the inspection. This was because it is a small service and we needed to be sure someone senior would be available to support the inspection. We also needed to obtain the consent from people using the service and relatives to be contacted by us to obtain feedback on their experience of using the service.

The inspection activity started on 24 June 2022 by visiting the provider's office to meet with the registered manager and contracts manager. We then made phone calls to people using the service, their relatives and staff, and inspection activity ended on 11 July 2022.

What we did before the inspection

We reviewed the information we had received about the service since they registered with us, including any statutory notifications received. We asked the provider to send us a provider information return. This is information providers are required to send us with key information about their service, what they do well and improvements they plan to make. We meet with the local authority monthly to gather their feedback on services. We used all this information to plan our inspection

During the inspection

We spoke with the registered manager and the contracts manager. We reviewed a range of records. These included care and staff records and records relating to the management of the service.

After the inspection

We spoke with two relatives of people using the service about their experiences of the care provided. No people using the service were available when we called. We spoke with one care worker. We continued to seek clarification from the provider to validate evidence found.

Updated 23 July 2022

About the service

Top Carers Nursing and Domiciliary Care Agency is a domiciliary and nursing care service. The service provides personal and nursing care to people living in their own homes. At the time of the inspection four people were receiving personal care and no people received nursing care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection some people were receiving support which did not include personal care and the provider also supplied staff to care homes and hospitals. We did not review the care they received as it is outside our regulatory remit.

People’s experience of using this service and what we found

The provider assessed risks to people to ensure staff had clear guidance to follow to reduce these risks. People’s medicines were managed safely and the registered manager carried out frequent checks of this. Staff were well trained in medicines management with assessments to check they were competent. Staff received formal and informal supervision with good recording systems so the provider could check the support staff received. The provider had a good system of audits in place to check people received the right standard of care.

The provider checked staff were suitable to work with people by undertaking the necessary recruitment checks. There were enough staff to support people safely and staff timekeeping was good. Staff followed suitable infection control practices, including the safe use of personal protective equipment (PPE) to reduce the risk of COVID19 transmission, and received training on this.

Staff received suitable training and support on how to meet people’s needs. People were supported to maintain their health and staff were trained to meet people’s specific needs. People received food and drink of their choice. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were caring and developed good relationships with people. People were supported to maintain and improve their independent living skills where this was an agreed part of their care. People received consistency of care from staff who knew them well. Staff treated people with dignity and respect. People were involved in their care and their care plan was based on their individual needs and preferences. The provider had a suitable complaints procedure in place and relatives had confidence any complaint would be investigated properly.

A registered manager was in post who was supported by a contracts officer and a senior nurse who also trained staff in specialist topics. Staff felt well supported by the management team. The provider engaged well with staff, people and relatives to ensure people received the care they needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection and update

This service was rated requires improvement at our inspection in June 2021 with breaches in safe care and treatment and good governance. We asked the provider to complete an action plan setting out how they would improve. At this inspection we found the provider had improved and was no longer in breach.

Why we inspected

This inspection was prompted to check the provider had followed their action plan and were meeting the regulations.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.